Yes

Benzodiazepine

Treatment of anxiety

D

Hypersensitivity to this drug or any component of its formulation (cross-sensitivity with other benzodiazepines may exist); narrow-angle glaucoma; pregnancy

Use with caution in elderly or debilitated patients, patients with hepatic disease (including alcoholics), or renal impairment. Use with caution in patients with respiratory disease, or impaired gag reflex. Avoid use in patients with sleep apnea.

Use caution in patients with depression, particularly if suicidal risk may be present. Use with caution in patients with a history of drug dependence. Benzodiazepines have been associated with dependence and acute withdrawal symptoms on discontinuation or reduction in dose. Acute withdrawal, including seizures, may be precipitated after administration of flumazenil to patients receiving long-term benzodiazepine therapy.

Benzodiazepines have been associated with anterograde amnesia. Paradoxical reactions, including hyperactive or aggressive behavior have been reported with benzodiazepines, particularly in adolescent/pediatric or psychiatric patients. Does not have analgesic, antidepressant, or antipsychotic properties.

Cardiovascular: Hypotension

Central nervous system: Drowsiness, fatigue, impaired coordination, lightheadedness, memory impairment, insomnia, depression, headache, anxiety, confusion, nervousness, syncope, dizziness, akathisia, drowsiness, ataxia, lightheadedness, vivid dreams

Dermatologic: Rash, pruritus

Endocrine & metabolic: Decreased libido, menstrual irregularities

Gastrointestinal: Xerostomia, constipation, diarrhea, decreased salivation, nausea, vomiting, increased or decreased appetite, increased salivation, weight gain or loss

Hematologic: Blood dyscrasias

Neuromuscular & skeletal: Dysarthria, tremor, muscle cramps, rigidity, weakness, reflex slowing

Ocular: Blurred vision, increased lenticular pressure

Otic: Tinnitus

Respiratory: Nasal congestion, hyperventilation

Miscellaneous: Diaphoresis, drug dependence

Decreased therapeutic effect: Carbamazepine, rifampin, rifabutin may enhance the metabolism of prazepam and decrease its therapeutic effect; consider using an alternative sedative/hypnotic agent

Increased toxicity: Cimetidine, ciprofloxacin, clarithromycin, clozapine, CNS depressants, diltiazem, disulfiram, digoxin, erythromycin, ethanol, fluconazole, fluoxetine, fluvoxamine, grapefruit juice, isoniazid, itraconazole, ketoconazole, labetalol, levodopa, loxapine, metoprolol, metronidazole, miconazole, nefazodone, omeprazole, phenytoin, rifabutin, rifampin, troleandomycin, valproic acid, verapamil may increase the serum level and/or toxicity of prazepam; monitor for altered benzodiazepine response

Binds to stereospecific benzodiazepine receptors on the postsynaptic GABA neuron at several sites within the central nervous system, including the limbic system, reticular formation. Enhancement of the inhibitory effect of GABA on neuronal excitability results by increased neuronal membrane permeability to chloride ions. This shift in chloride ions results in hyperpolarization (a less excitable state) and stabilization.

Duration: 48 hours

Serum half-life:

Parent drug: 78 minutes

Desmethyldiazepam: 30-100 hours

Adults: Oral: 30 mg/day in divided doses, may increase gradually to a maximum of 60 mg/day

No information available to require special precautions

>10% of patients experience dry mouth which disappears with cessation of drug therapy

Avoid alcohol and other CNS depressants; avoid activities needing good psychomotor coordination until CNS effects are known; drug may cause physical or psychological dependence; avoid abrupt discontinuation after prolonged use

Capsule: 5 mg, 10 mg, 20 mg

Tablet: 5 mg, 10 mg